Evidence map›Paper›PMID 41702420›Full record

ReviewJournal of inherited metabolic disease2026

Medicine Development and Access for Rare Diseases: Can We Do Better?

Carla E M Hollak, Noa Rosenberg, Colinda Post, Nina Stolwijk, Evert Manders, Daphne Schoenmakers, Bart Penninx, Niels Reijnhout, Kathelijn Verdeyen, Roel Jonker and 5 more

Abstract readReview
In one paragraph

Review in Journal of inherited metabolic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Medicine Development and Access for Rare Diseases: Can We Do Better?Journal of inherited metabolic disease · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Carla E M HollakDepartment of Endocrinology and Metabolism, Amsterdam UMC, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Expertise Center for Inborn Errors of Metabolism, University of Amsterdam, Amsterdam, the Netherlands.ORCID https://orcid.org/0000-0003-0464-1078
Noa RosenbergMedicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Colinda PostDepartment of Endocrinology and Metabolism, Amsterdam UMC, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Expertise Center for Inborn Errors of Metabolism, University of Amsterdam, Amsterdam, the Netherlands.
Nina StolwijkMedicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.ORCID https://orcid.org/0000-0002-3498-5747
Evert MandersMedicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Daphne SchoenmakersMedicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Bart PenninxMedicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Niels ReijnhoutMedicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Kathelijn VerdeyenMedicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Roel JonkerMedicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Annet M BoschEmma Children's Hospital, Department of Pediatrics, Division of Metabolic Diseases, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Expertise Center for Inborn Errors of Metabolism, University of Amsterdam, Amsterdam, the Netherlands.
Mirjam LangeveldDepartment of Endocrinology and Metabolism, Amsterdam UMC, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Expertise Center for Inborn Errors of Metabolism, University of Amsterdam, Amsterdam, the Netherlands.ORCID https://orcid.org/0000-0002-9934-6831
Vincent van der WelMedicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Saco de VisserMedicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Sibren van den BergMedicines for Society (Medicijn voor de Maatschappij), Platform at Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Funding

Lottery Health ResearchNationale Postcode Loterij
6 · The paper itself

Abstract

Recent advances in molecular biology and genomics have significantly enhanced our understanding of rare diseases. While enabling the development of highly targeted therapies, it also leads to complexity in the development, regulation, and accessibility of orphan medicines. Unmet need and great promise of new medicines, combined with high prices and uncertain effectiveness, highlight the shortcomings of the system, particularly evident for highly specialized treatment options, such as advanced therapy medicinal products and RNA-based treatments. While all stakeholders in this field must take responsibility, academic researchers and clinicians have a vital role which must be strengthened to improve access to and affordability of medicines. Regarding academia-driven orphan medicine development, academic contributions are predominantly concentrated in the early research phases, often lacking continuity throughout the full development pipeline. There is limited expertise in regulatory affairs and market access, and little involvement in medicine pricing or licensing negotiations. Recommendations include sustained academic engagement across all development stages, integration of regulatory and market access training into educational programs, and the implementation of socially responsible frameworks. Strategies promoting the rational use of orphan medicines should be embedded across the entire product lifecycle. Industry-driven development typically interacts primarily with regulatory agencies and payers, with academia playing a reactive and, at times, conflicted role. Independent academic-industry interaction is recommended, with early involvement in clinical trial design. Additionally, academia should proactively contribute to the evaluation of new therapies, development of controlled access models, and exploration of sustainable pricing frameworks. Establishing independent, multi-purpose disease registries would enhance post-authorization monitoring and evidence generation.

Indexed as

Drug DevelopmentHealth Services AccessibilityOrphan Drug ProductionRare DiseasesAcademiaDrug IndustryHumans

Identifiers

PMID41702420
PMCPMC12912821

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.